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Pleurectomy/Decortication With Intraoperative Intrathoracic/Intraperitoneal Heated Cisplatin With Sodium Thiosulfate

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ClinicalTrials.gov Identifier: NCT00165503
Recruitment Status : Terminated (lack of acurral)
First Posted : September 14, 2005
Results First Posted : September 9, 2016
Last Update Posted : September 9, 2016
Sponsor:
Collaborator:
Brigham and Women's Hospital
Information provided by (Responsible Party):
David J. Sugarbaker, MD, Dana-Farber Cancer Institute

Study Description
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Brief Summary:
The purposes of this study are: to determine the feasibility of administering adjuvant cisplatin plus ALIMTA to patients who undergo surgery with heated cisplatin during surgery; to determine the effects (good and bad) of this combined modality approach in patients with mesothelioma; to evaluate cisplatin effects by determining where it goes and how it is excreted in the body from the collection of tissues and cisplatin samples; to collect and analyze discarded samples of mesothelioma tumor during surgery to help determine the genetic make-up of the disease.

Condition or disease Intervention/treatment Phase
Pleural Mesothelioma Malignant Pleural Mesothelioma Drug: Cisplatin Drug: Sodium Thiosulfate Drug: ALIMTA Phase 2

Detailed Description:

OBJECTIVES:

Primary

  • To determine the feasibility of administering adjuvant cisplatin plus Alimta to patients undergoing surgery with hyperthermic cisplatin.

Secondary

  • To determine the morbidity and mortality of this treatment protocol
  • To determine time to tumor recurrence and patient survival
  • To evaluate the pharmacokinetics of intraoperatively administered cisplatin

DETAILS:

  • Patients will undergo surgery, which is part of the standard care for mesothelioma, by a procedure called pleurectomy/decortication. This involves removal of the lining of the lung and all visible disease. Resection of the lining of the heart and the muscle that separates the chest and abdomen is occasionally necessary.
  • Mesothelioma samples will be taken during the surgery. These samples will be used in a laboratory study to better understand the genetic makeup of the mesothelioma and to improve our ability to diagnose this disease.
  • After the conclusion of the surgery, if a patient has less than 1cm thickness of residual gross disease in one or more areas, then the patient will continue on this study. If more than this volume of tumor is present, then the patient will receive additional treatment off-study.
  • Heated chemotherapy (cisplatin) will be given in the operating room immediately following surgery. This treatment consists of a one-hour lavage of the chest and abdominal cavity with heated cisplatin through the surgical incision. At the completion of the hour, sodium thiosulfate is given intravenously for 6 hours to reduce potential side effects.
  • During the surgery and for four hours following the completion of the cisplatin lavage, blood samples, urine samples, chest wall muscle samples, and samples of the chemotherapy solution will be taken in order to measure the concentration of chemotherapy and the impact of cisplatin in these samples.
  • Patients will remain in the hospital until they have recovered from surgery (7-14 days). In addition to standard post-operative care, blood tests will be done on a daily basis. Following discharge from the hospital, patients will be seen 1-2 weeks post-operatively for additional blood work. An echocardiogram will be done 6 weeks and 6 months post-operatively to assess heart function.
  • Chemotherapy treatment consists of ALIMTA plus cisplatin on Day 1 of every 21-day chemotherapy cycle. A total of 3 cycles will be given starting 6-10 weeks after surgery.
  • Folic acid, vitamin B12 and dexamethasone will be given in addition to the chemotherapy to help reduce side effects of the chemotherapy drugs.
  • Approximately 30 days after the last dose of ALIMTA plus cisplatin, a CT scan(s) and blood work will be performed. In addition, patients will get a CT scan(s) every 3 months for approximately 24 months from the completion of study treatment.
  • Long term follow-up will consist of clinic visits every 3 months for 2 years, every 6 months for 2 years, and then once a year.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 16 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: A Phase II Feasibility Study of Pleurectomy/Decortication With Intraoperative Intrathoracic/Intraperitoneal Heated Cisplatin With Sodium Thiosulfate Followed ny Adjuvant ALIMTA/Cisplatin
Study Start Date : April 2004
Actual Primary Completion Date : July 2010
Actual Study Completion Date : July 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Mesothelioma

Arms and Interventions
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Arm Intervention/treatment
Experimental: Surgery+Heated Cisplatin+Sodium Thiosulfate+Adjuvant CT
Participants undergo surgery, Pleurectomy/Decortication, followed by heated cisplatin given as a one-hour lavage of the chest and abdominal cavity then sodium thiosulfate given intravenously over 6 hours. The adjuvant chemotherapy regimen beginning 6-10 weeks after surgery is a combination of cisplatin and Alimta each given day 1 of a 21-day cycle for 3 cycles.
 Drug: Cisplatin
Drug: Sodium Thiosulfate
Drug: ALIMTA
Other Name: pemetrexed


Outcome Measures
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Primary Outcome Measures :
  1. Adjuvant Chemotherapy Completion Rate [ Time Frame: Given the 21-day cycle, 3 cycles of adjuvant chemotherapy approximates 9 weeks in addition to the time from registration and post-surgery which was up to 10 weeks. ]
    Feasibility in this study was based on the adjuvant chemotherapy regimen. The chemotherapy completion rate is defined as the percentage of patients who complete 3 cycles of cisplatin and Alimta beginning 6-10 weeks after surgery with hyperthermic cisplatin.


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histopathologic confirmation of malignant pleural mesothelioma
  • Patients who are able to tolerate surgical cytoreduction but unable to undergo extrapleural pneumonectomy due to poor cardiopulmonary reserve or tumor invasion or those with minimal disease
  • Male on non-pregnant female
  • 18 years of age or older
  • No evidence of spread outside the ipsilateral hemithorax by chest CT and chest MRI
  • Ejection fraction > 45%
  • Pre-operative WBC > 4K/uL
  • Estimated life expectancy of at least 12 weeks
  • Evidence of adequate renal and hepatic function
  • Grossly normal contralateral pulmonary function with a chest radiograph and chest CT scan
  • Karnofsky performance status of 70% or greater
  • No evidence of disease progression by chest CT or chest MRI, obtained at 8 weeks following surgery

Exclusion Criteria:

  • Extended disease outside the ipsilateral hemithorax as determined on pre-operative radiographs or intraoperative findings
  • Positive extrapleural nodes as determined by mediastinoscopy
  • Gross disease (estimated thickness > 10mm at any intrathoracic location) present within the hemithorax after surgery
  • Evidence of distant metastatic disease
  • Severe non-malignant co-morbid disease, uncontrolled angina, myocardial infarction on the past 6 months, renal insufficiency, liver disease, pulmonary hypertension
  • Pregnant or breast-feeding
  • Serious concomitant systemic disorders
  • Presence of active concomitant malignancy
  • Psychiatric or addictive disorders, which would preclude informed consent
  • Previous chemotherapy or radiation therapy for mesothelioma
  • Chemotherapy or radiation therapy administered within 3 years for another malignancy
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00165503


Locations
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United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Dana-Farber Cancer Institute
Brigham and Women's Hospital
Investigators
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Principal Investigator: David J. Sugarbaker, MD Brigham and Women's Hospital
More Information
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Responsible Party: David J. Sugarbaker, MD, Principal Investigator, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier: NCT00165503    
Other Study ID Numbers: 04-063
First Posted: September 14, 2005    Key Record Dates
Results First Posted: September 9, 2016
Last Update Posted: September 9, 2016
Last Verified: July 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by David J. Sugarbaker, MD, Dana-Farber Cancer Institute:
pleurectomy
decortication
cisplatin
ALIMTA
Additional relevant MeSH terms:
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Mesothelioma
Mesothelioma, Malignant
Adenoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Mesothelial
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Pleural Neoplasms
Lung Diseases
Respiratory Tract Diseases
Sodium thiosulfate
 Pemetrexed
Antineoplastic Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors
Antidotes
Protective Agents
Physiological Effects of Drugs
Antioxidants
Antitubercular Agents
Anti-Bacterial Agents
Anti-Infective Agents
Chelating Agents
Sequestering Agents